| 引用本文： |
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刘莺,桂亚平,吴登龙,等.ESWL与输尿管镜激光碎石治疗输尿管下段结石的前瞻性研究[J].同济大学学报（医学版）,2015,36(1):96-100. [点击复制]
- LIU Ying,GUI Ya-ping,WU Deng-long,et al.Extracorporeal shockwave lithotripsy vs ureteroscopic laser lithotripsy for management of lower ureteral calculi: a prospective study[J].同济大学学报（医学版）,2015,36(1):96-100. [点击复制]
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| 摘要: |
| 目的比较超声定位下电磁式 体外冲击波碎石术(extracorporeal shock wave lithotripsy, ESWL)和输尿管镜下U100Plus激光碎石(ureteroscopic laser lithotripsy, URL)治疗输尿管下段结石的疗效和安全性。方法 2013年2月至2014年1月治疗输尿管下段结石患者142例,根据患者意愿分为ESWL(35例)和URL(107例)两组,每组再根据结石的大小分为≥10mm和＜10mm 2个亚组,治疗后4周复查比较结石排净率、并发症和费用。结果URL组单次碎石成功率、总结石排净率均优于ESWL组,且重复治疗率低(P＜0.05),但ESWL组的平均治疗时间短、总费用相对较少(P＜0.05)。亚组内比较,结石＜10mm者行ESWL疗效(单次碎石成功率和总结石排净率)明显优于结石≥10mm者；而结石大小与URL疗效无明显关系。亚组间比较,结石＜10mm者,ESWL与URL疗效类似；结石≥10mm者,URL疗效优于ESWL(P＜0.05)。各亚组组内和组间比较并发症发生率差异无统计学意义。结论 URL治疗输尿管下段结石的总体疗效优于ESWL。若结石＜1cm时,可首选ESWL；结石≥1cm时,URL更适用。 |
| 关键词: 输尿管结石 体外冲击波碎石术 输尿管镜 |
| DOI：10.16118/j.1008-0392.2015.01.021 |
| 投稿时间：2014-06-30 |
| 基金项目: |
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| Extracorporeal shockwave lithotripsy vs ureteroscopic laser lithotripsy for management of lower ureteral calculi: a prospective study |
| LIU Ying,GUI Ya-ping,WU Deng-long,YUAN Tao,BIAN Cui-dong |
| (Dept. of Urology, Tongji Hospital, Tongji University, Shanghai 200065, China) |
| Abstract: |
| Objective To compare the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic laser lithotripsy (URL) in management of lower ureteral calculi. MethodsOne hundred and forty three patients with lower ureteral calculi were enrolled in a prospective trial from February 2013 to January 2014. The treatment modality chosen for an individual was primarily based on patient choice: 35 patients underwent ESWL and 107 patients underwent URL. The electromagnetic lithotripter was used for ESWL and double-frequency laser was used for URL. Patients in both groups were compared for overall stone-free rates (SFR), complication rates and costs after 4 weeks. A subgroup analysis was performed in both groups according to stone size of <10mm or ≥10mm. ResultsCompared with ESWL group, the success rate on one session and overall SFR in URL group was significantly higher, and the re-treatment rate was significantly lower(P＜0.05), whereas the average treatment time was significantly shorter and the cost was lower in ESWL group (P＜0.05). In ESWL group, the efficacy was significantly higher in patients with stones <10mm (P＜0.05) than that with stones ≥10mm, however thare was no statistical differences between two subgroups in the URL groups.In patients with stones ≥10mm treated with URL, the efficacy was significantly higher for those treated with ESWL (P＜0.05). There was no significant difference in incidence of complication between two groups and subgroups. ConclusionFor the management of lower ureteral calculi, URL has a better therapeutic effect than ESWL. ESWL can be the preferred for patients with lower ureteral calculi <10mm and URL can be reserved for patients with stones of ≥10mm. |
| Key words: ureteral calculi extracorporeal shock wave lithotripsy ureteroscopy |
